Ethics guidelines for hand surgeons

The American Society for Surgery of the Hand (ASSH) Corporate Advisory Council recently gathered in Chicago to create the first ever, ethics guidelines, to be followed by hand surgeons. The ASSH has been an industry leader in developing standards to both embrace the support of industry partners, while also ensuring that such support is accepted without conditions or restrictions.

In 2008, the Corporate Relations Committee was formed by the ASSH Board of Directors (Council) as a means of monitoring and developing clean and ethical relationships. While serving as President of the ASSH at the time, Steven Z. Glickel, MD, conceived the initial concept of a “10 Commandments”. Dr. Glickel, Chair of the Hand Service at Roosevelt Hospital in New York City, believed it was necessary to develop a clearly defined standard to be followed by hand surgeons. In doing so, any appearance of impropriety or the perception that a physician’s ability to independently make decisions regarding the care of a patient, patient would be avoided. William Seitz, Jr., MD., served as the ASSH Commercial Support Chair when Dr. Glickel, conceived the idea. They worked together to make the initial idea, an actual reality. Dr. Seitz, who is at the Cleveland Clinic, is now Chair of the newly formed Corporate Advisory Council. Robert Szabo, MD, (UC Davis) is the current ASSH President and he continues the work to support the initiative. ASSH’s “10 Commandments” will be strictly adhered to by physicians and corporations. L. Andrew Koman, MD, Chair of the Department of Orthopaedics at Wake Forest, was also a key surgeon and President at the time the Corporate Advisory Council held its inaugural meeting.

The following guidelines are also part of the American Foundation for Surgery of the Hand’s (AFSH) commitment to having the highest ethical relationships with the industry in support of hand and upper extremity research. Fred Fakharzadeh, MD, current President of the AFSH, believes these “commandments” will help both industry leaders and surgeons have the kind of relationship that will ultimately benefit patients.

The following 10 Commandments are as follows:

It is the belief of the leadership of the ASSH, that a relationship between medical societies representing physicians and commercial corporations is necessary and beneficial for the future of medicine. It is essential for industry to consult with physicians for their medical expertise. It is also necessary for the medical professionals to rely on industry to support education in order to stay abreast of the latest technology within their chosen field.

In order to avoid any appearance of impropriety or perception that a physician’s ability to independently make decisions regarding the care of the patient has been compromised, we will henceforth strictly adhere to these following guidelines (“our ten commandments”):

• Industry is strongly encouraged to support educational activities to increase knowledge and the skills necessary to improve patient care through the American Society for Surgery of the Hand (ASSH).
• Industry is strongly encouraged to provide support for research through the American Foundation for Surgery of the Hand (AFSH). The subject and content of the research will be determined by the ASSH/AFSH. Corporations will not control the content of supported research.
• The ASSH/AFSH will clearly define research programs and methods of selection of topics and researchers receiving donated funds. The AFSH will provide annual updates to donors on the use of those funds.
• Physicians will be consulted and involved in the development and design of new products as deemed necessary by the device company following a comprehensive review of the specific project requirements as well as the physicians’ credentials, qualifications and expertise on the subject matter by the company.
• Consulting and design activities will be reimbursed by industry at a fair market value on a per-activity or per-time basis. No ASSH members will accept gifts, funding for companion travel, sponsorship of recreational activity, entertainment or sports events.
• ASSH Members and industry will be parties to explicit contracts regarding the scope of service and reimbursement for service.
• ASSH members will not demand or accept unreasonable reimbursement for travel, meals, and lodging, for being involved in an educational activity.
• All funding to support education and research will be controlled by the ASSH and the AFSH.
• Companies will not influence the control of educational or research activities.
• All relationships will be disclosed and readily available to the public.

Source: American Society for the Surgery of the Hand